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Cuesta P, Bruña R, Shah E, Laohathai C, Garcia-Tarodo S, Funke M, Von Allmen G, Maestú F. An individual data-driven virtual resection model based on epileptic network dynamics in children with intractable epilepsy: a magnetoencephalography interictal activity application. Brain Commun 2023; 5:fcad168. [PMID: 37274829 PMCID: PMC10236945 DOI: 10.1093/braincomms/fcad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 01/24/2023] [Accepted: 05/23/2023] [Indexed: 06/07/2023] Open
Abstract
Epilepsy surgery continues to be a recommended treatment for intractable (medication-resistant) epilepsy; however, 30-70% of epilepsy surgery patients can continue to have seizures. Surgical failures are often associated with incomplete resection or inaccurate localization of the epileptogenic zone. This retrospective study aims to improve surgical outcome through in silico testing of surgical hypotheses through a personalized computational neurosurgery model created from individualized patient's magnetoencephalography recording and MRI. The framework assesses the extent of the epileptic network and evaluates underlying spike dynamics, resulting in identification of one single brain volume as a candidate for resection. Dynamic-locked networks were utilized for virtual cortical resection. This in silico protocol was tested in a cohort of 24 paediatric patients with focal drug-resistant epilepsy who underwent epilepsy surgery. Of 24 patients who were included in the analysis, 79% (19 of 24) of the models agreed with the patient's clinical surgery outcome and 21% (5 of 24) were considered as model failures (accuracy 0.79, sensitivity 0.77, specificity 0.82). Patients with unsuccessful surgery outcome typically showed a model cluster outside of the resected cavity, while those with successful surgery showed the cluster model within the cavity. Two of the model failures showed the cluster in the vicinity of the resected tissue and either a functional disconnection or lack of precision of the magnetoencephalography-MRI overlapping could explain the results. Two other cases were seizure free for 1 year but developed late recurrence. This is the first study that provides in silico personalized protocol for epilepsy surgery planning using magnetoencephalography spike network analysis. This model could provide complementary information to the traditional pre-surgical assessment methods and increase the proportion of patients achieving seizure-free outcome from surgery.
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Affiliation(s)
- Pablo Cuesta
- Correspondence to: Pablo Cuesta Pza. Ramón y Cajal, s/n. Ciudad Universitaria 28040 Madrid, Spain E-mail:
| | - Ricardo Bruña
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, 28040, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, 28040, Spain
| | - Ekta Shah
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | | | - Stephanie Garcia-Tarodo
- Département de la femme, de l'enfant et de l'adolescent, Hôpital des Enfants - Hôpitaux Universitaires de Genève, Geneva, 1211 Genève 14, Switzerland
| | - Michael Funke
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Gretchen Von Allmen
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Fernando Maestú
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, 28040, Spain
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, 28040, Spain
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Universidad Complutense de Madrid, Madrid, 28040, Spain
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Blanchard-Rohner G, Hofer M, Garcia-Tarodo S. [Which immunological pathologies are targeted by precision medicine?]. Rev Med Suisse 2023; 19:370-373. [PMID: 36815327 DOI: 10.53738/revmed.2023.19.815.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Pediatric immune disorders encompass an array of disorders with either a systemic or tissue-specific expression, whose phenotype and therapeutic approach often depend on age. More recently, genotypic traits and knowledge of the underlying pathophysiological processes have facilitated a more individualized clinical approach. Molecular characterization in primary immune disorders has provided molecular targets for immunotherapies. In immune-mediated disorders of the CNS, better recognition of pediatric characteristics has enabled earlier diagnosis and treatment initiation. For rhumatismal disorders, like all rare immune disorders, the setting up of multi-centre registers and collaborative studies provide the framework for targeted clinical strategies.
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Affiliation(s)
- Géraldine Blanchard-Rohner
- Unité d'immunologie-vaccinologie pédiatrique, Service de pédiatrie générale, Département de la femme, de l'enfant et de l'adolescent, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Michael Hofer
- Unité romande d'immuno-rhumatologie pédiatrique, Service de pédiatrie, Centre hospitalier universitaire vaudois, Université de Lausanne, et Département de la femme, de l'enfant et de l'adolescent, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Stephanie Garcia-Tarodo
- Unité de neurologie pédiatrique, Service des spécialités, Département de la femme, de l'enfant et de l'adolescent, Hôpitaux universitaires de Genève, 1211 Genève 14
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3
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Chauvet E, Blanchard Rohner G, Manel V, Delmont E, Boucraut J, Garcia-Tarodo S. Autoantibodies to a Nodal Isoform of Neurofascin in Pediatric Chronic Inflammatory Demyelinating Polyneuropathy. Child Neurol Open 2023; 10:2329048X221149618. [PMID: 36816544 PMCID: PMC9936388 DOI: 10.1177/2329048x221149618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 02/18/2023] Open
Abstract
Pediatric chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder of the peripheral nervous system with a number of diagnostic pitfalls. A subset of treatment-resistant CIDP adult patients have been found with antibodies against paranodal proteins. We report the first pediatric case in a 14 year-old adolescent with a severe CIDP phenotype in whom positive anti-neurofascin 155 antibodies were found in his serum. Resistant to conventional therapies, he showed dramatic improvement when treated with Rituximab with mild to moderate functional motor disability at 24 month follow-up. In pediatric CIDP patients that remain refractory to conventional treatments, the presence of antibodies to paranodal proteins warrants investigation as it can have potential therapeutic guidance.
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Affiliation(s)
- Eline Chauvet
- Unit of Neuropediatrics, Department of Women, Children and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Geraldine Blanchard Rohner
- Immunology, Department of Women, Children and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Véroniqu Manel
- Hospices Civils De Lyon, Groupement Hospitalier EST, Hopital Femme Mere Enfant, Bron, France
| | - Emilien Delmont
- Referral Centre for Neuromuscular Disease and ALS, La Timone Hospital, Marseille, France
| | - Joseph Boucraut
- immunology Department, La Conception Hospital, Marseille, France
| | - Stephanie Garcia-Tarodo
- Unit of Neuropediatrics, Department of Women, Children and Adolescent, Geneva University Hospitals, Geneva, Switzerland,Stephanie Garcia-Tarodo, Unit of Neuropediatrics, Department of Women, Children and Adolescent, Geneva University Hospitals, Switzerland.
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Watkins MW, Shah EG, Funke ME, Garcia-Tarodo S, Shah MN, Tandon N, Maestu F, Laohathai C, Sandberg DI, Lankford J, Thompson S, Mosher J, Von Allmen G. Indications for Inpatient Magnetoencephalography in Children - An Institution's Experience. Front Hum Neurosci 2021; 15:667777. [PMID: 34149382 PMCID: PMC8213217 DOI: 10.3389/fnhum.2021.667777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
Magnetoencephalography (MEG) is recognized as a valuable non-invasive clinical method for localization of the epileptogenic zone and critical functional areas, as part of a pre-surgical evaluation for patients with pharmaco-resistant epilepsy. MEG is also useful in localizing functional areas as part of pre-surgical planning for tumor resection. MEG is usually performed in an outpatient setting, as one part of an evaluation that can include a variety of other testing modalities including 3-Tesla MRI and inpatient video-electroencephalography monitoring. In some clinical circumstances, however, completion of the MEG as an inpatient can provide crucial ictal or interictal localization data during an ongoing inpatient evaluation, in order to expedite medical or surgical planning. Despite well-established clinical indications for performing MEG in general, there are no current reports that discuss indications or considerations for completion of MEG on an inpatient basis. We conducted a retrospective institutional review of all pediatric MEGs performed between January 2012 and December 2020, and identified 34 cases where MEG was completed as an inpatient. We then reviewed all relevant medical records to determine clinical history, all associated diagnostic procedures, and subsequent treatment plans including epilepsy surgery and post-surgical outcomes. In doing so, we were able to identify five indications for completing the MEG on an inpatient basis: (1) super-refractory status epilepticus (SRSE), (2) intractable epilepsy with frequent electroclinical seizures, and/or frequent or repeated episodes of status epilepticus, (3) intractable epilepsy with infrequent epileptiform discharges on EEG or outpatient MEG, or other special circumstances necessitating inpatient monitoring for successful and safe MEG data acquisition, (4) MEG mapping of eloquent cortex or interictal spike localization in the setting of tumor resection or other urgent neurosurgical intervention, and (5) international or long-distance patients, where outpatient MEG is not possible or practical. MEG contributed to surgical decision-making in the majority of our cases (32 of 34). Our clinical experience suggests that MEG should be considered on an inpatient basis in certain clinical circumstances, where MEG data can provide essential information regarding the localization of epileptogenic activity or eloquent cortex, and be used to develop a treatment plan for surgical management of children with complicated or intractable epilepsy.
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Affiliation(s)
- Michael W Watkins
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - Ekta G Shah
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - Michael E Funke
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Department of Neurology, McGovern Medical School, Houston, TX, United States
| | - Stephanie Garcia-Tarodo
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Pediatric Neurology Unit, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Manish N Shah
- Department of Neurosurgery, McGovern Medical School, Houston, TX, United States.,Division of Pediatric Neurosurgery, Department of Pediatric Surgery, McGovern Medical School, Houston, TX, United States
| | - Nitin Tandon
- Department of Neurosurgery, McGovern Medical School, Houston, TX, United States
| | - Fernando Maestu
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Complutense and Universidad Politecnica de Madrid, Madrid, Spain.,Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Christopher Laohathai
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - David I Sandberg
- Department of Neurosurgery, McGovern Medical School, Houston, TX, United States.,Division of Pediatric Neurosurgery, Department of Pediatric Surgery, McGovern Medical School, Houston, TX, United States
| | - Jeremy Lankford
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States
| | - Stephen Thompson
- Department of Neurology, McGovern Medical School, Houston, TX, United States
| | - John Mosher
- Department of Neurology, McGovern Medical School, Houston, TX, United States
| | - Gretchen Von Allmen
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, TX, United States.,Department of Neurology, McGovern Medical School, Houston, TX, United States
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Pérez CA, Garcia-Tarodo S, Troxell R. MRI-Negative Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Antibody Spectrum Demyelinating Disease. Child Neurol Open 2019; 6:2329048X19830475. [PMID: 30800700 PMCID: PMC6379793 DOI: 10.1177/2329048x19830475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/20/2019] [Accepted: 01/21/2019] [Indexed: 11/16/2022] Open
Abstract
Myelin oligodendrocyte glycoprotein is expressed in the central nervous system on the
surface of oligodendrocytes and is associated with a broad range of adult and pediatric
demyelinating phenotypes. The entire spectrum of clinical and radiologic features of
myelin oligodendrocyte glycoprotein antibody spectrum disorder remains to be fully
elucidated. We describe the case of a 9-year-old boy with immune-mediated myelitis
undetectable by conventional magnetic resonance imaging in the context of relapsing
anti-myelin oligodendrocyte glycoprotein spectrum disorder. Despite the severe clinical
presentation, his symptoms improved significantly following treatment with
corticosteroids. Because timely diagnosis and treatment is imperative to prevent disease
recurrence and reduce long-term morbidity, serum anti-myelin oligodendrocyte glycoprotein
antibody testing should be considered in all children with acute demyelinating syndromes
and unusual clinical presentations—including seizures—both at presentation and at
follow-up.
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Affiliation(s)
- Carlos A Pérez
- Division of Child and Adolescent Neurology, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Stephanie Garcia-Tarodo
- Division of Child and Adolescent Neurology, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Regina Troxell
- Division of Child and Adolescent Neurology, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA
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Garcia-Tarodo S, Datta AN, Ramelli GP, Maréchal-Rouiller F, Bien CG, Korff CM. Circulating neural antibodies in unselected children with new-onset seizures. Eur J Paediatr Neurol 2018; 22:396-403. [PMID: 29291919 DOI: 10.1016/j.ejpn.2017.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/04/2017] [Accepted: 12/11/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The role of autoimmunity and neural antibodies is increasingly recognized in different forms of seizures and epilepsy. Their prevalence in new-onset epilepsy has also recently been the focus of several clinical cohorts in the adult and pediatric population, with positive titers in 10-11% of cases. Our aim was to determine the seropositivity at the first seizure onset in a non-selective group of children. METHOD We conducted a prospective multicenter cohort study recruiting children aged 0-16 years with new-onset seizures presenting at the In- and Outpatient Pediatric Neurology Departments of three Children's Hospitals in Switzerland between September 2013 and April 2016. Neural antibodies were screened within the first 6 months of a first seizure and when positive, repeated at 1 month and 6 months follow-up. RESULTS A total of 103 children were enrolled with a mean age at presentation of 5 years (range 1 day-15 years 9 months). The majority (n = 75) presented with generalized seizures and 6 had status epilepticus lasting > 30 min. At the time of onset, 55% of patients had fever, 24% required emergency seizure treatment and 27% hospitalization. Epilepsy was diagnosed at follow-up in 18%. No specific antibody was found. Serum antibodies against the VGKC complex, without binding to the specific antigens LGI1 and CASPR2, were found in two patients. Four patients harbored not otherwise characterized antibodies against mouse neuropil. INTERPRETATION Specific neural antibodies are rarely found in an unselected population of children that present with a first seizure. Applying an extensive neuronal antibody profile in a child with new-onset seizures does not appear to be justified.
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Affiliation(s)
- Stephanie Garcia-Tarodo
- Paediatric Neurology Unit, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Alexandre N Datta
- Department of Pediatric Neurology and Developmental Medicine, University of Basel, Children's Hospital, Basel, Switzerland
| | - Gian P Ramelli
- Department of Paediatrics, Regional Hospital San Giovanni, Bellinzona, Switzerland
| | | | | | - Christian M Korff
- Paediatric Neurology Unit, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.
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7
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Ranza E, Garcia-Tarodo S, Varvagiannis K, Guipponi M, Lobrinus JA, Bottani A, Kern I, Kurian M, Pittet MP, Antonarakis SE, Fluss J, Korff CM. SERPINI1 pathogenic variants: An emerging cause of childhood-onset progressive myoclonic epilepsy. Am J Med Genet A 2017; 173:2456-2460. [PMID: 28631894 DOI: 10.1002/ajmg.a.38317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 05/16/2017] [Indexed: 12/16/2023]
Abstract
Progressive myoclonic epilepsies are rare neurodegenerative diseases with a wide spectrum of clinical presentations and genetic heterogeneity that render their diagnosis perplexing. Discovering new imputable genes has been an ongoing process in recent years. We present two pediatric cases of progressive myoclonic epilepsy with SERPINI1 pathogenic variants that lead to a severe presentation; we highlight the importance of including this gene, previously known as causing an adult-onset dementia-epilepsy syndrome, in the genetic work-up of childhood-onset progressive myoclonic epilepsies.
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Affiliation(s)
- Emmanuelle Ranza
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stephanie Garcia-Tarodo
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | | | - Michel Guipponi
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Johannes A Lobrinus
- Neuropathology Unit, Department of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Armand Bottani
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ilse Kern
- Pediatric Metabolism Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Mary Kurian
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Pascale Pittet
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Stylianos E Antonarakis
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Genetic Medicine and Development, University of Geneva Medical Faculty, Geneva, Switzerland
- iGE3 Institute of Genetics and Genomics of Geneva, Geneva, Switzerland
| | - Joel Fluss
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
| | - Christian M Korff
- Pediatric Neurology Unit, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
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Fluss J, Garcia-Tarodo S, Granier M, Villega F, Ferey S, Husson B, Kossorotoff M, Muehlethaler V, Lebon S, Chabrier S. Perinatal arterial ischemic stroke related to carotid artery occlusion. Eur J Paediatr Neurol 2016; 20:639-48. [PMID: 27025300 DOI: 10.1016/j.ejpn.2016.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 03/02/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aetiology of perinatal arterial ischemic stroke remains speculative. It is however widely accepted that the aetiology is multifactorial, involving various maternal, placental, foetal and neonatal risk factors. A resulting thromboembolic process is hypothesized and the placenta identified as the most plausible source. An arteriopathy, as observed in a significant proportion of childhood ischemic stroke, is thought to be rare. METHODS We report here five cases of perinatal stroke that differ from the vast majority by documented carotid occlusion, and add eleven other similar cases from the literature. RESULTS In the majority, an intraluminal thrombus of placental origin is the most probable hypothesis, while in the remaining ones, one can reasonably presume a direct vessel wall injury related to a traumatic delivery, yet generally unproven by imaging. CONCLUSION We hypothesize that most of these cases share similar pathophysiology with the more common perinatal arterial ischemic stroke but differ by a persistent identified thrombus in the carotid artery at the time of first imaging, leading to a more severe and extended ischemic damage responsible for an adverse neurological outcome.
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Affiliation(s)
- Joel Fluss
- Pediatric Neurology Unit, Pediatric Subspecialities Service, Children's Hospital, Geneva University Hospitals, Switzerland.
| | - Stephanie Garcia-Tarodo
- Pediatric Neurology Unit, Pediatric Subspecialities Service, Children's Hospital, Geneva University Hospitals, Switzerland
| | - Michèle Granier
- Neonatal Unit, Sud-Francilien Hospital Centre, Corbeil, France
| | - Frédéric Villega
- Pediatric Neurology, Children's Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Solène Ferey
- Unit of Pediatric Radiology, Children's Hospital, Geneva University Hospitals, Switzerland
| | - Béatrice Husson
- French Centre for Pediatric Stroke and Pediatric Radiology, Bicêtre University Hospital Centre, Le Kremlin-Bicêtre, France
| | - Manoelle Kossorotoff
- French Centre for Pediatric Stroke, Pediatric Neurology Department, APHP-Necker-Enfants Malades, University Hospital, Paris, France
| | - Vincent Muehlethaler
- Neonatal Unit, Department of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland
| | - Sebastien Lebon
- Pediatric Neurology Unit, Department of Pediatrics, Lausanne University Hospital, Switzerland
| | - Stéphane Chabrier
- French Centre for Pediatric Stroke, University Hospital Centre of Saint-Etienne, 42055 Saint-Etienne Cedex 2, France
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Garcia-Tarodo S, Bottani A, Merlini L, Kaelin A, Schwitzgebel VM, Parvex P, Dayer R, Lascombes P, Korff CM. Widespread intracranial calcifications in the follow-up of a patient with cartilage-hair hypoplasia--anauxetic dysplasia spectrum disorder: a coincidental finding? Eur J Paediatr Neurol 2015; 19:367-71. [PMID: 25596067 DOI: 10.1016/j.ejpn.2014.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 12/04/2014] [Accepted: 12/25/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND/PURPOSE Intracranial calcifications have been identified in many neurological disorders. To our knowledge, however, such findings have not been described in cartilage-hair hypoplasia - anauxetic dysplasia spectrum disorders (CHH-AD), a group of conditions characterized by a wide spectrum of clinical manifestations. METHODS/RESULTS We report a 22-year old female patient, diagnosed with this disorder during her first year of life, and in whom bilateral intracranial calcifications (frontal lobes, basal ganglia, cerebellar dentate nuclei) were discovered by brain MRI at the age of 17 years. CONCLUSION The etiology of this finding remains unclear. Some causes of such deposits can be of a reversible nature, thus prompting early recognition although their consequences on clinical outcome remain mostly unknown.
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Affiliation(s)
- S Garcia-Tarodo
- Pediatric Neurology, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - A Bottani
- Service of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - L Merlini
- Medical Radiology, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - A Kaelin
- Pediatric Orthopedics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - V M Schwitzgebel
- Pediatric Endocrinology, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - P Parvex
- Pediatric Nephrology, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - R Dayer
- Pediatric Orthopedics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - P Lascombes
- Pediatric Orthopedics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - C M Korff
- Pediatric Neurology, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.
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